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Consent to Receive Text Messages from Ashley Addiction Treatment

By checking this box and submitting this form, you agree to receive text messages from Ashley Addiction Treatment about your care, including appointment reminders and health information.
These messages may include information about your participation in substance use disorder treatment. Your information is protected by federal law (42 CFR Part 2) and HIPAA. We will not share information about your treatment without your written consent, except as permitted by law. Message frequency will vary. Message and data rates may apply. You can opt out at any time by replying STOP. Consent is not required to receive care. For help, reply HELP or contact us at [Contact Number?]. For more information, see our Notice of Privacy Practices. You may revoke your consent at any time. Your consent will be recorded and maintained as part of your health record.